Surgical cutting of the fibula — the slender outer bone of the lower leg — typically involving removal of a wedge-shaped bone segment to correct alignment or facilitate adjacent joint procedures.
Verified May 8, 2026 · 4 sources ↓
- Medicare
- $392.46
- Work RVU
- 4.66
- Global, days
- 90
- Region
- Foot & ankle
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 4 cited references ↓
- Specify the surgical indication — deformity correction, length discrepancy, ankle arthroplasty access, or other — in the operative note
- Describe the osteotomy technique explicitly: wedge resection, transverse cut, oblique cut, and bone volume removed if applicable
- Document whether the fibular osteotomy was a distinct procedure or adjunct to an ankle arthroplasty, including separate incision and instrumentation details
- Record intraoperative fluoroscopy use and whether it was integral to this procedure or used for a separately billable service
- Identify laterality — left or right fibula — in both the operative note and the procedure order
- Include preoperative imaging or clinical findings that establish medical necessity for the osteotomy
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 4 cited references ↓
CPT 27707 describes a fibular osteotomy, a procedure in which the surgeon cuts through the fibula, often removing a wedge of bone, to correct angular deformity, address length discrepancy, or create access for reconstruction of the ankle or distal leg. The fibula's role in ankle mortise stability and tibiotalar alignment makes this osteotomy relevant in deformity correction and as an adjunct to total ankle arthroplasty, where fibular access or realignment is surgically necessary.
The 90-day global period means all routine postoperative care through day 90 is bundled into the payment. A known NCCI bundling question arises when 27707 is billed same-day with total ankle arthroplasty (27702) — payers scrutinize whether the fibular osteotomy is integral to the arthroplasty approach or a separately identifiable service. Document the distinct surgical indication and technique to support unbundling with modifier 59 where appropriate. Fluoroscopy used intraoperatively is not separately billable unless it supports a distinct additional procedure performed the same day.
When performed on one leg, append LT or RT. If bilateral fibular osteotomies are performed at the same operative session — unusual but possible in bilateral deformity correction — use modifier 50. For procedures requiring substantially greater work than typical, modifier 22 requires a supporting operative note explaining the added complexity.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (4.66) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (11.75) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 4.66 |
| Practice expense RVU | 6.2 |
| Malpractice RVU | 0.89 |
| Total RVU | 11.75 |
| Medicare national rate | $392.46 |
| Global period | 90 days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $392.46 |
HOPD (APC 5113) Hospital outpatient department | $3,342.87 |
ASC (PI A2) Ambulatory surgical center (freestanding) | $1,644.87 |
Common denial reasons
The recurring reasons claims for CPT 27707 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Bundling denial when billed same-day with total ankle arthroplasty (27702) without adequate documentation of distinct surgical indication and technique
- Lacking laterality modifier (LT or RT) causing claim rejection or payer request for additional information
- Medical necessity not established — diagnosis codes fail to support the need for fibular osteotomy as a standalone or adjunct procedure
- Missing or vague operative note language such as 'standard osteotomy performed' without specifying technique, bone volume, or surgical rationale
- Fluoroscopy billed separately when payer considers it integral to the osteotomy procedure
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 4 cited references ↓
01Can I bill 27707 with total ankle arthroplasty (27702) on the same day?
02What modifier applies when 27707 is performed on only one leg?
03What global period applies to 27707?
04Can I bill intraoperative fluoroscopy separately with 27707?
05When is modifier 22 appropriate for 27707?
06Is 27707 appropriate for a fibular osteotomy performed as part of ankle fracture fixation?
Sources & references
Editorial content was developed using the following public sources. Last verified May 8, 2026.
Mira Scribe
Mira's AI scribe captures the fibular osteotomy technique from dictation — wedge dimensions, cut orientation, fixation method, and the clinical indication driving the osteotomy — and flags whether the procedure is documented as distinct from any concurrent ankle arthroplasty. That distinction is what separates a clean 27707 claim from a bundling denial when 27702 is billed the same day.
See how Mira captures CPT 27707 documentation